“Patient Lost to Follow-up”: Opportunities and Challenges in Delivering Primary Care in Academic Medical Centers

Amat, Maelys; Duralde, Erin; Masutani, Rebecca; Glassman, Rebecca; Shen, Changyu

doi:10.1007/s11606-021-07216-3

Cited by 8 publications

(3 citation statements)

References 11 publications

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Section: Discussionsupporting

confidence: 80%

“…As mentioned previously, non-White patients have been found to have an increased risk of being lost to follow-up over time. 20 The median household income finding joins previously published literature demonstrating that increased median household income is significantly associated with longer length of follow-up. 33 The final multivariate model focused on identifying factors related to increased number of postoperative images and identified a significant association with higher initial grade of tumor (β, 4.61; SE, 2.04) (P = .02), pathology diagnosis of medulloblastoma (β, 37.63; SE, 8.15) (P < .001), and increased number of visits to the emergency room (β, 1.41; SE, 0.26) (P < .001).…”

Section: Multivariate Analysis Models For Sdoh and Postoperative Outc...supporting

confidence: 80%

“…This echoes previous findings where non-White identification and use of public insurance were significantly associated with being lost to follow-up. 20 Patients with public insurance or a decreased median household income are more likely to use emergency rooms to avoid the higher out-of-pocket costs often associated with an outpatient clinic, despite facing greater barriers to care in emergency departments. 21,22 The aggregated effect of Black race, lower household income, and insurance status needs to be further studied and better defined to identify possible solutions.…”

Section: Patients Lost To Follow-upmentioning

confidence: 99%

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Social Determinants of Health and Associations With Outcomes in Pediatric Patients With Brain Tumors

et al. 2023

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BACKGROUND AND OBJECTIVES: Social determinants of health (SDOH) are nonmedical factors that affect health outcomes. Limited investigation has been completed on the potential association of these factors to adverse outcomes in pediatric populations. In this study, the authors aimed to analyze the effects of SDOH disparities and their relationship with outcomes after brain tumor resection or biopsy in children. METHODS: The authors retrospectively reviewed the records of their center's pediatric patients with brain tumor. Black race, public insurance, median household income, and distance to hospital were the investigated SDOH factors. Univariate analysis was completed between number of SDOH factors and patient demographics. Multivariate linear regression models were created to identify coassociated determinants and outcomes. RESULTS: A total of 272 patients were identified and included in the final analysis. Among these patients, 81 (29.8%) had no SDOH disparities, 103 (37.9%) had 1, 71 (26.1%) had 2, and 17 (6.2%) had 3. An increased number of SDOH disparities was associated with increased percentage of missed appointments (P = .002) and emergency room visits (P = .004). Univariate analysis demonstrated increased missed appointments (P = .01), number of postoperative imaging (P = .005), and number of emergency room visits (P = .003). In multivariate analysis, decreased median household income was independently associated with increased length of hospital stay (P = .02). CONCLUSION: The SDOH disparities are prevalent and impactful in this vulnerable population. This study demonstrates the need for a shift in research focus toward identifying the full extent of the impact of these factors on postoperative outcomes in pediatric patients with brain tumor.

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Section: Discussionsupporting

confidence: 80%

Section: Multivariate Analysis Models For Sdoh and Postoperative Outc...supporting

confidence: 80%